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Stage 4 Metastatic - what to expect after 6 months
In November I was diagnosed with metastatic prostate cancer. I had a PSA of 5000, Gleason score of 9, and the cancer had spread to lymph nodes, many bones, and I had small spot on my lungs.
We are approaching 6 months since the diagnosis. I did triple therapy of chemo (Docetaxel), Nubeqa, Firmagon. I've finished 18 weeks of the chemo and have transitioned to Eligard (along with continued Nubeqa). My PSA at last check was 2.2 and PET scans showed no new tumor growth and significant tumor shrinkage.
I will start 28 rounds of radiation on my prostate next week.
I'm 55, have continued to exercise daily, and have changed my diet quite a bit. I'm struggling mainly with fatigue, hot flashes, and some leg swelling.
I'd love to connect with anyone with a similar diagnosis.
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Thank you for sharing. I was in a similar situation to yourself 2/3 months ago but my PSA started rising again after firmagon, docetaxel, Orgovyx and Nubeqa took my PSA to 2.07. My oncoligist arranged FoundationOne Liquid CDx 'Molecular Tumour Biomarker Testing' for me, and I expect results at the end of next week or early the following week. As of today I'm still taking Orgovyx (Relugolix) and Nubeqa (Darokutamide) daily, I have some right hip and groin pain at times that panadol seems to contain at present. Until the test results are back and analysed I won't know what the plan for me will be. Targeted therapy has been mentioned. I hope your good treatment continues. I will report on here again shortly.
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Is there some reason you have not had a PSMA Pet scan. It sounds like you’ve got some bone metastasis that could be zapped with SBRT radiation.
Doing that scan would allow you to have targeted therapy. The biomarker really is not going to help in that regard, You need the scan to see what’s going on.
Staying on the drugs, can be beneficial, If they can zap the metastasis, you have, then the drugs can usually prevent it from reoccurring.
@jeffmarc : please see my original post:
I was diagnosed with Advanced Prostate Cancer in May 2025 my PSA was 340. Following 2+5 monthly Firmagon injections, that overlapped with 6 docetaxel infusions given every 3 weeks, my PSA was down to 2.07 on 07 Jan 2026. I was put on Relugolix and Darolutamide a month or so before the doxetaxel finished but on 24 Apr 2026, following a PSMA-Pet scan that lit up showing active tumors, my PSA had gone up to 7.6. The PSA was 44 on 09 Jun 2026. I have an appointment on Monday 22 Jun 2026 with one of the top oncologists in the country. I'm hopeful that there will be follow-on treatment.